COMPARISON OF CASE-BASED PAYMENT AND FEE-FOR-SERVICES PAYMENT IN HOSPITAL POLYCLINICS
ABSTRACT
The aim of this study is to compare the case-based payment and the fee-for-service payment
methods in terms of hospital revenues for policlinics payments to hospitals. This research is a
retrospective, cross-sectional, registry-based study. The research was conducted in an A2 group
Ministry of Health Turkey hospital operating in Izmir. Study data belong to 2019 year. In the study,
the data of 34 policlinics that the hospital serves, excluding the emergency outpatient clinic, were
examined. A total of 1,096,135 applications were examined in policlinics, 21 of which belong
to the general specialty and 13 to the subspecialty. 60.45% of the patients who applied to the
general specialty policlinics and 67.80% of the patients who applied to the subspecialty policlinics
were women; the mean ages were 42.62±22.281 and 38.45±23,221, respectively. According to
the findings of the study, the ratio of the payment per case to the payment fee-for-service differs
according to the type of the policlinics. In eight of the 21 major general specialty polyclinics and
in seven of the 13 subspecialty polyclinics, the per-case payment is not enough to cover the
transactions included in the per-case payment. Another finding of the study is that, in general,
the average payment per patient of the Social Security Institution is higher than the amount of
payment per case. The existence of additional billable transactions can explain this situation. We
found the income-expense coverage ratio of the hospital to be 93.95% in the general specialty
polyclinics and 82.62% in the subspecialty polyclinics, and 92.87% in total. It has been concluded
that in the hospital policlinics payments, payments per case create a disadvantage for the hospital
compared to payments fee-for-service payment.
Author(s)
Emine ÇETİN ASLAN
